| NPI | 1023604691 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | AMBER BROOKS Business Manager 972-542-6662 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics |
| Enumeration Date | 2020-12-17 |
| Last Update Date | 2020-12-17 |